A study in The Lancet Regional Health finds that wide disparities in healthcare capacity in the United States, particularly in rural areas, hampered COVID-19 vaccination efforts during the pandemic.
The cross-sectional study was conducted by comparing the healthcare system capacity of 2,417 US counties and their COVID-19 vaccination rates. Counties with more limited healthcare capacity had COVID-19 vaccination rates less than or equal to 50%, with 35% higher constraints in low-vaccinated areas compared to high-vaccinated areas.
The average number of medical doctors per 1,000 in low-vaccinated counties was 0.19 (95% confidence interval [CI], 0.18 to 0.20) compared to 0.81 (0.76 to 0.85) in high-vaccinated ones.
While most research has focused on vaccine hesitancy as being a lead cause of regional vaccine disparities in the United States, this study showed lack of healthcare coverage also contributed to gaps between urban and rural Americans.
Disruption to health services was felt most acutely in rural areas, and people in underserved communities were as much as 34% less likely to be vaccinated against COVID-19. Nevada, Montana, North Dakota, South Dakota, and Nebraska had the lowest vaccination rates.
"Many counties, especially those in rural areas, experienced significant disruptions in health care, including the distribution of the COVID-19 vaccine itself," said study co-author Neil MacKinnon, PhD, provost for Augusta University in Georgia, in a press release.